Sarcoidosis, Vasculitis, and Diffuse Lung Diseases最新文献

{"title":"Diagnostic and therapeutic practices of cardiac sarcoidosis in the United States: a nationwide questionnaire based study.","authors":"Moustafa Younis,&nbsp;Abdullah Abu Kar,&nbsp;Mohammad Abdel Jawad,&nbsp;Yazan Al-Zamer,&nbsp;Diala Alawneh,&nbsp;Divya Patel,&nbsp;Borna Mehrad,&nbsp;Bashar Alzghoul","doi":"10.36141/svdld.v40i3.14218","DOIUrl":"10.36141/svdld.v40i3.14218","url":null,"abstract":"<p><strong>Background and aim: </strong>Cardiac sarcoidosis (CS) is the second most common cause of death in patients with sarcoidosis and data pertaining to its diagnosis and management is limited. We sought to describe diagnostic modalities and management of patients with CS in the United States, based on a national registry questionnaire.</p><p><strong>Methods: </strong>We conducted a retrospective study based on a national registry investigating 3,835 respondents to the Foundation for Sarcoidosis Research Questionnaire. The registry includes patient surveys completed between June 2014 and August 2019. Summary and univariate analyses were performed.</p><p><strong>Results: </strong>A total of 394 patients (10.3%) with CS were identified; 57% (n=223) were women and 81% (n=317) were white. The mean (±SD) age at diagnosis was 45 years (±13). CS was the initial presentation of sarcoidosis in 30%. Multiorgan involvement (≥3 organs) was present in 68%. Two-thirds of patients were admitted at least once to the hospital. Cardiac magnetic resonance imaging (74.4%) was the most common diagnostic modality used followed by positron emission tomography (PET) scan (59.3%) and cardiac biopsy (n=52, 13%).  Most patients received corticosteroids (86%) and steroid-sparing medications (61%) including methotrexate (26%) and tumor necrosis factor (TNF) inhibitors (19%). A combined cardioverter defibrillator and pacemaker (39%) was the most common cardiac device implanted.</p><p><strong>Conclusions: </strong>The prevalence of CS in this cohort was higher than previously described. CS was a common initial presentation of sarcoidosis. The diagnosis was most likely made using cMRI. Steroids, methotrexate and infliximab are the most common medications used. Conduction abnormalities and arrhythmias often occurred.</p>","PeriodicalId":21394,"journal":{"name":"Sarcoidosis, Vasculitis, and Diffuse Lung Diseases","volume":"40 3","pages":"e2023032"},"PeriodicalIF":1.6,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f9/66/SVDLD-40-32.PMC10540711.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10609969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary hypertension in ANCA-associated vasculitis: a retrospective analysis.","authors":"Misbah Baqir,&nbsp;Narayana Sarma Singam,&nbsp;Hilary DuBrock","doi":"10.36141/svdld.v40i2.13631","DOIUrl":"10.36141/svdld.v40i2.13631","url":null,"abstract":"<p><strong>Background: </strong>Little is known about pulmonary hypertension (PH) in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).</p><p><strong>Objectives: </strong>The aims of this retrospective study, in which echocardiography was used for detection of PH, were to identify the potential causes of PH in AAV and to analyze the risk factors for mortality.</p><p><strong>Methods: </strong>We performed a retrospective descriptive review of 97 patients who had AAV with PH at our institution from January 1, 1997, through December 31, 2015. These patients with PH were compared with 558 patients who had AAV without PH. Demographic and clinical data were abstracted from electronic health records.</p><p><strong>Results: </strong>Among the patients who had PH, 61% were men; mean (SD) age was 70.5 (14.1) years at the time of PH diagnosis. The majority of patients with PH (73.2%) had more than 1 potential cause of PH, with left heart disease and chronic lung disease being the most common causes. Older age, male sex, smoking history, and kidney involvement were associated with the presence of PH. PH was associated with an increased risk of death (hazard ratio, 3.15; 95% CI, 2.37-4.18). On multivariate analysis, PH, age, smoking status, and kidney involvement were independent risk factors for death. Median survival after the diagnosis of PH was 25.9 months (95% CI, 12.2-49.9).</p><p><strong>Conclusions: </strong>PH in AAV is often multifactorial, is commonly associated with left heart disease, and is associated with a poor prognosis.</p>","PeriodicalId":21394,"journal":{"name":"Sarcoidosis, Vasculitis, and Diffuse Lung Diseases","volume":"40 2","pages":"e2023020"},"PeriodicalIF":1.6,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/35/5d/SVDLD-40-20.PMC10494752.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10567813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frontal cutaneous and bone sarcoidosis: an example of the contiguous spread of granulomas.","authors":"Sara Braga,&nbsp;Florence Jeny,&nbsp;Marjorie Latrasse,&nbsp;Nathalie Saidenberg Kermanac'h,&nbsp;Stéphane Tran Ba,&nbsp;Hilario Nunes","doi":"10.36141/svdld.v40i2.14594","DOIUrl":"https://doi.org/10.36141/svdld.v40i2.14594","url":null,"abstract":"<p><p>Sarcoidosis is a multisystemic granulomatous disease of unknown origin. It has been argued that the skin is one of the entry doors of the possible antigen that causes sarcoidosis and after entering the skin, the causal agent may progress to the underlying bone. We report four cases with development of sarcoidosis in old scars located on the forehead, and contiguous bone involvement of the frontal bone. In most cases scar sarcoidosis was the first manifestation of the disease, and in most cases it was asymptomatic. Two patients never required treatment, and in all cases the frontal problem improved or remained stable spontaneously or under sarcoidosis treatment. Scar sarcoidosis in the frontal area may have contiguous bone damage. This bone involvement does not seem to be associated with neurological extension.</p>","PeriodicalId":21394,"journal":{"name":"Sarcoidosis, Vasculitis, and Diffuse Lung Diseases","volume":"40 2","pages":"e2023023"},"PeriodicalIF":1.6,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/ee/SVDLD-40-23.PMC10494748.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10584580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Krebs von den Lungen-6 (KL-6) in cerebrospinal fluid from neurosarcoidosis patients.","authors":"Silvia Bocci,&nbsp;Miriana D'Alessandro,&nbsp;Laura Bergantini,&nbsp;Alfonso Cerase,&nbsp;Monica Ulivelli,&nbsp;Paola Rottoli,&nbsp;Dalila Cavallaro,&nbsp;Sara Gangi,&nbsp;Elena Bargagli,&nbsp;Fabio Giannini","doi":"10.36141/svdld.v40i2.12900","DOIUrl":"https://doi.org/10.36141/svdld.v40i2.12900","url":null,"abstract":"<p><strong>Background: </strong>Krebs von den Lungen-6 (KL-6) is a high molecular weight (MW) glycoprotein mainly secreted by type II pneumocytes because of lung damage or during regeneration. Neurosarcoidosis (NS), where sarcoid granulomas involve the nervous system, occurs in 5-20% of patients with sarcoidosis. No data is currently available on KL-6 in serum or CSF of NS patients. The present study compared KL-6 concentrations in serum and CSF of NS patients versus others with neurodegenerative (ND) or chronic inflammatory demyelinating (DM) diseases.</p><p><strong>Materials and methods: </strong>Nine NS patients (mean age 46.2 years, range 16-61 years, M/F 5/4), nine patients with a chronic neurodegenerative disease (mean age 53.1 years, range 37-65 years, M/F 5/4) and nine patients with a chronic demyelinating disease (mean age 46.3 years, range 18-65 years, M/F 5/4) were retrospectively enrolled.</p><p><strong>Results: </strong>Measurable CSF concentrations of KL-6 were detected in 7/9 NS patients but in no ND or DM patients. No significant differences in CSF concentrations of ACE were observed between the three groups (p=0.0819). In NS patients, CSF concentrations of KL-6 were directly correlated with CSF albumin index (r=0.98; p<0.0001), albumin (r=0.979, p=0.0001), IgG (r=0.928, p=0.0009) and total protein concentrations (r=0.945, p=0.0004).</p><p><strong>Discussion: </strong>KL-6 is a high MW protein, under physiological conditions it is unlikely to cross the blood-brain barrier. We found KL-6 in CSF from NS and not from ND and DM patients. The finding sustains the specificity of changes in KL-6 in this granulomatous disease, suggesting it as a candidate biomarker for recognition of NS.</p>","PeriodicalId":21394,"journal":{"name":"Sarcoidosis, Vasculitis, and Diffuse Lung Diseases","volume":"40 2","pages":"e2023019"},"PeriodicalIF":1.6,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/54/35/SVDLD-40-19.PMC10494755.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10272536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT findings in \"Post-Covid\": residua from acute pneumonia or \"Post-Covid-ILD\"?","authors":"Stefanie Meiler,&nbsp;Florian Poschenrieder,&nbsp;Arno Mohr,&nbsp;Quirin Strotzer,&nbsp;Gregor Scharf,&nbsp;Janine Rennert,&nbsp;Christian Stroszczynski,&nbsp;Michael Pfeifer,&nbsp;Okka Hamer","doi":"10.36141/svdld.v40i2.13983","DOIUrl":"https://doi.org/10.36141/svdld.v40i2.13983","url":null,"abstract":"<p><p>The aim of this study was to evaluate if CT findings in patients with pulmonary Post Covid syndrome represent residua after acute pneumonia or if SARS-CoV 2 induces a true ILD. Consecutive patients with status post acute Covid-19 pneumonia and persisting pulmonary symptoms were enrolled. Inclusion criteria were availability of at least one chest CT performed in the acute phase and at least one chest CT performed at least 80 days after symptom onset. In both acute and chronic phase CTs 14 CT features as well as distribution and extent of opacifications were independently determined by two chest radiologists. Evolution of every single CT lesion over time was registered intraindividually for every patient. Moreover, lung abnormalities were automatically segmented using a pre-trained nnU-Net model and volume as well as density of parenchymal lesions were plotted over the entire course of disease including all available CTs. 29 patients (median age 59 years, IQR 8, 22 men) were enrolled. Follow-up period was 80-242 days (mean 134). 152/157 (97 %) lesions in the chronic phase CTs represented residua of lung pathology in the acute phase. Subjective and objective evaluation of serial CTs showed that CT abnormalities were stable in location and continuously decreasing in extent and density. The results of our study support the hypothesis that CT abnormalities in the chronic phase after Covid-19 pneumonia represent residua in terms of prolonged healing of acute infection. We did not find any evidence for a Post Covid ILD.</p>","PeriodicalId":21394,"journal":{"name":"Sarcoidosis, Vasculitis, and Diffuse Lung Diseases","volume":"40 2","pages":"e2023024"},"PeriodicalIF":1.6,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cd/54/SVDLD-40-24.PMC10494745.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10567809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing feasibility of targeted primary care referrals for patients with clinical suspicion of interstitial lung disease using lung ultrasound: a prospective case finding study. The potential benefits of LUS utilization.","authors":"Emmanouil Symvoulakis,&nbsp;Eirini Vasarmidi,&nbsp;Manolis Linardakis,&nbsp;Alexandros Tsiavos,&nbsp;Aikaterini Mantadaki,&nbsp;Georgios Pitsidianakis,&nbsp;Andreas Karelis,&nbsp;Chrysi Petraki,&nbsp;Kadiani Nioti,&nbsp;Stelios Mastronikolis,&nbsp;Nikolaos Tzanakis,&nbsp;Antoniou K Eraclion Crete","doi":"10.36141/svdld.v40i2.14017","DOIUrl":"https://doi.org/10.36141/svdld.v40i2.14017","url":null,"abstract":"<p><strong>Background: </strong>In Primary Health Care (PHC) many interstitial lung disease (ILD) cases may remain at diagnostic delay, due to their challenging presentation and the limited experience of general practitioners (GPs) in recognizing their early symptoms.</p><p><strong>Objective: </strong>We have designed a feasibility study to investigate early ILD case-finding competency between PHC and tertiary care.</p><p><strong>Methods: </strong>A cross-sectional prospective case-finding study was launched at two private health care centers of Heraklion, Crete, Greece, during nine months (2021-2022). After clinical assessment by GP, PHC attenders, who agreed to participate in the study, were referred to the Respiratory Medicine Department, University Hospital of Heraklion, Crete, underwent Lung Ultrasound (LUS) and those with an overall suspicion for ILDs underwent high resolution computed tomography (HRCT) scan. Descriptive statistics and chi-square tests were used. Multiple Poisson regression analysis was performed to explain positive LUS and HRCT decision with selected variables.</p><p><strong>Results: </strong>One hundred and nine patients out of 183 were finally included (54.1% females; mean age 61, SD: 8.3 years). Thirty-five (32.1%) were current smokers. Overall, two out of ten cases were assessed to need HRCT due to a moderate or high suspicion (19.3%; 95%CI 12.7, 27.4). However, in those who had dyspnea in relation to counterparts, a significantly higher percentage of patients with LUS findings (57.9% vs. 34.0%, p=0.013) was found, as in those who had crackles (100.0% vs. 44.2%, p= 0.005). Detected possible ILD provisional labelling cases were 6, and most importantly, 5 of those cases were considered highly suspicious for further evaluation based on LUS findings.</p><p><strong>Conclusions: </strong>This is a feasibility study exploring potentials by combining data of medical history, basic auscultation skills, as crackles detection, and inexpensive and radiation-free imaging technique, such as LUS. Cases of ILD labeling may be hidden within PHC, sometimes, much before any clinical manifestation.</p>","PeriodicalId":21394,"journal":{"name":"Sarcoidosis, Vasculitis, and Diffuse Lung Diseases","volume":"40 2","pages":"e2023022"},"PeriodicalIF":1.6,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/bb/SVDLD-40-22.PMC10494744.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10567810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel biomarkers for the assessment of disease activity in patients with sarcoidosis: a case-control study.","authors":"Hosam Hosny Masoud,&nbsp;Amani Moustafa Ali,&nbsp;Fatma AbdelWahab,&nbsp;Hoda M Abdel-Hamid","doi":"10.36141/svdld.v40i2.14327","DOIUrl":"https://doi.org/10.36141/svdld.v40i2.14327","url":null,"abstract":"<p><strong>Background and aim: </strong>The prognosis of sarcoidosis is challenging and largely depends on the persistence of disease activity and the degree of organ dysfunction. Various biomarkers have been evaluated for diagnosis, disease activity assessment, and prognosis. This study aimed to determine if the ratios of monocytes to high-density lipoprotein cholesterol (MHR), platelets to lymphocytes (PLR), neutrophils to lymphocytes (NLR), and lymphocytes to monocytes ratio (LMR) could be used as novel sarcoidosis activity markers.</p><p><strong>Methods: </strong>In a case-control study, 54 patients with biopsy-confirmed sarcoidosis were divided into two groups; group 1: consisted of 27 patients with active sarcoidosis who were newly diagnosed and treatment-naive, and group 2: consisted of 27 patients with inactive sarcoidosis who had been on treatment for at least 6 months. All patients were subjected to a comprehensive history, physical examination, laboratory tests, chest imaging, spirometry, and screening for extrapulmonary organ involvement by means of electrocardiogram and eye examination.</p><p><strong>Results: </strong>The mean age of the patients was 44 ± 11 years (79.6% were females & 20.4% were males). MHR, NLR, and LMR were significantly higher in patients with active sarcoidosis than in an inactive disease with a cut-off value of 8.6, a sensitivity of 81.5%, and a specificity of 70.4% (P-value < 0.001), a cut-off value of 1.95, sensitivity of 74% and specificity of 66.7% (P-value 0.007) and a cut-off value of < 4, a sensitivity of 81.5%, and a  specificity of 85.2% (P-value < 0.001), respectively. In contrast, PLR was not statistically significant between active and inactive sarcoidosis patients.</p><p><strong>Conclusions: </strong>The lymphocytes monocytes ratio is a highly sensitive and specific biomarker that could be used to assess the disease activity in sarcoidosis patients.</p>","PeriodicalId":21394,"journal":{"name":"Sarcoidosis, Vasculitis, and Diffuse Lung Diseases","volume":"40 2","pages":"e2023017"},"PeriodicalIF":1.6,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/88/SVDLD-40-17.PMC10494756.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10584585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of a new parameter in functional assessment in patients with idiopathic pulmonary fibrosis: desaturation - distance ratio from the six-minute walk test.","authors":"Rıdvan Aktan,&nbsp;Kemal Can Tertemiz,&nbsp;Salih Yiğit,&nbsp;Sevgi Özalevli,&nbsp;Aylin Özgen Alpaydın,&nbsp;Eyüp Sabri Uçan","doi":"10.36141/svdld.v40i2.14634","DOIUrl":"https://doi.org/10.36141/svdld.v40i2.14634","url":null,"abstract":"Background and aim: New parameters in the 6-minute walk test (6MWT) are needed for assessing exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). To our knowledge, no previous study has investigated the potential of using the desaturation distance ratio (DDR) to assess exercise capacity specifically in patients with IPF. This study aimed to investigate whether DDR is a potential tool for assessing the exercise capacity of patients with IPF. Methods: This study conducted with 33 subjects with IPF. Pulmonary function tests and a 6MWT were performed. To calculate the DDR, first, the difference between the patient’s SpO2 at each minute and the SpO2 of 100% was summed together to determine the desaturation area (DA). Next, DDR was calculated using dividing DA by the 6-minute walk test distance (6MWD) (i.e., DA/6MWD). Results: When correlations of 6MWD and DDR with changes (Δ) in the severity of perceived dyspnea were examined, 6MWD did not significantly correlate with ΔBorg. Conversely, there was a significant correlation between the DDR and ΔBorg (r= 0.488, p=0.004). There were significant correlations between 6MWD and FVC % (r=0.370, p=0.034), and FEV1 % (r=0.465, p=0.006). However, DDR was significantly more correlated with FVC % (r= -0.621, p< 0.001), FEV1 % (r= -0.648, p< 0.001). Moreover, there was a significant correlation between DDR and DLCO % (r= -0.342, p=0.052). Conclusions: The findings of this study suggest that DDR is a promising and more useful parameter for assessing patients with IPF.","PeriodicalId":21394,"journal":{"name":"Sarcoidosis, Vasculitis, and Diffuse Lung Diseases","volume":"40 2","pages":"e2023021"},"PeriodicalIF":1.6,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ed/0a/SVDLD-40-21.PMC10494751.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10584586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of 6-minute walk test for assessing severity of interstitial lung disease: an observational study.","authors":"Zhan-Wei Hu,&nbsp;Li Gao,&nbsp;Qing Yu,&nbsp;Zhe Jin,&nbsp;Ju-Hong Liu,&nbsp;Yuan-Yuan Lian,&nbsp;Cheng-Li Que","doi":"10.36141/svdld.v40i2.13991","DOIUrl":"https://doi.org/10.36141/svdld.v40i2.13991","url":null,"abstract":"<p><strong>Background: </strong>The 6-minute walk test (6MWT) is a potential tool for assessing the severity of interstitial lung disease (ILD).</p><p><strong>Objectives: </strong>To explore the relationship between 6MWT results and traditional measures including pulmonary function and chest computed tomography(CT) and to determine factors that might influence the 6-minute walk distance (6MWD).</p><p><strong>Methods: </strong>Seventy-three patients with ILD were enrolled at Peking University First Hospital. All patients underwent 6MWT, pulmonary CT, and pulmonary function tests and their correlations were analyzed. Multivariate regression analysis was used to identify factors that might impact 6MWD.  Results: Thirty (41.4%) of the patients were female and the mean age was 66.1 ± 9.6 years. 6MWD was correlated with forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), total lung capacity (TLC), diffusing capacity for carbon monoxide (DLCO) and DLCO%pred. The decrease in oxygen saturation (SpO2) after the test was correlated with FEV1%pred, FVC%pred, TLC, TLC%pred, DLCO, DLCO%pred and the percentage of normal lung calculated by quantitative CT. The increase in Borg dyspnea scale was correlated with FEV1, DLCO and the percentage of normal lung. The backward multivariate model (F = 15.257, P < 0.001, adjusted R2 = 0.498) indicated that 6MWD was predicted by age, height, body weight, increase in heart rate, and DLCO.</p><p><strong>Conclusions: </strong>The 6MWT results were closely correlated with pulmonary function and quantitative CT in patients with ILD. However, in addition to disease severity, 6MWD was also influenced by individual characteristics and the degree of patient effort, which should thus be considered by clinicians when interpreting 6WMT results.</p>","PeriodicalId":21394,"journal":{"name":"Sarcoidosis, Vasculitis, and Diffuse Lung Diseases","volume":"40 2","pages":"e2023013"},"PeriodicalIF":1.6,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/da/SVDLD-40-13.PMC10494753.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10567812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of patients with diffuse alveolar hemorrhage diagnosed by cytological examination of 1000 bronchoalveolar lavage samples.","authors":"Pallavi Prasad,&nbsp;Aviral Gupta,&nbsp;Alok Nath,&nbsp;Zia Hashim,&nbsp;Mansi Gupta,&nbsp;Narendra Krishnani,&nbsp;Ajmal Khan","doi":"10.36141/svdld.v40i1.13413","DOIUrl":"https://doi.org/10.36141/svdld.v40i1.13413","url":null,"abstract":"Background and aim: Diffuse alveolar hemorrhage (DAH) is a life-threatening condition due to the extravasation of blood in the alveoli, resulting in hypoxemia and even acute respiratory distress syndrome. This study aimed to describe the clinico-radio-pathological profile of patients diagnosed with DAH and classify it into immune and nonimmune DAH. Methods: This was a retrospective analytical study. Of a total of 1000 cases of bronchoalveolar lavage fluids (BALF) received for cytological examination, patients fulfilling the clinical, radiological, and laboratory details of cases satisfying the clinical and cytological criteria of DAH (n=47) were studied. Results: The most common cause of immune DAH was ANCA-associated vasculitis (n=13, 27.6%), and that of nonimmune DAH was infections (n=10, 21.3%). Twenty-nine patients (61.7%) had hemoptysis. The most common radiological finding was ground-glass opacities (n=33, 70.2%). In univariate analysis, female sex, mean hemoglobin at admission, total leucocyte count (TLC), platelet count, and erythrocyte sedimentation rate (ESR) were significantly associated with immune-DAH. However, in multivariate analysis, female sex, higher TLC, high platelets, and high ESR were significantly associated with immune DAH. Patients were treated with corticosteroids (n=25, 46.3%), intravenous cyclophosphamide (n=12, 22.2%), plasma exchange (n=7, 13.0%), intravenous immunoglobulin (n=5, 9.3%) and rituximab (n=5, 9.3%). The overall mortality was 8.5% (n=4). Conclusions: DAH is a life-threatening syndrome that may be classified into immune and nonimmune DAH. Immune-DAH requires aggressive management, whereas nonimmune DAH cases respond best to conservative management.","PeriodicalId":21394,"journal":{"name":"Sarcoidosis, Vasculitis, and Diffuse Lung Diseases","volume":"40 1","pages":"e2023004"},"PeriodicalIF":1.6,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d9/39/SVDLD-40-4.PMC10099654.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9299445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}